Loading…

Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study

This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early child...

Full description

Saved in:
Bibliographic Details
Published in:International journal of environmental research and public health 2022-09, Vol.19 (17), p.11043
Main Authors: Benítez Marín, María José, Blanco Elena, Juan Antonio, Marín Clavijo, Jesús, Jiménez López, Jesús, Lubián López, Daniel María, González Mesa, Ernesto
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c421t-9534051578093e59c4014f2b872c276002a07d790d62e06fc9af9823e3fb0c7b3
cites cdi_FETCH-LOGICAL-c421t-9534051578093e59c4014f2b872c276002a07d790d62e06fc9af9823e3fb0c7b3
container_end_page
container_issue 17
container_start_page 11043
container_title International journal of environmental research and public health
container_volume 19
creator Benítez Marín, María José
Blanco Elena, Juan Antonio
Marín Clavijo, Jesús
Jiménez López, Jesús
Lubián López, Daniel María
González Mesa, Ernesto
description This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support. It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied. The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient. We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.
doi_str_mv 10.3390/ijerph191711043
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9518559</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2712851559</sourcerecordid><originalsourceid>FETCH-LOGICAL-c421t-9534051578093e59c4014f2b872c276002a07d790d62e06fc9af9823e3fb0c7b3</originalsourceid><addsrcrecordid>eNpdkUtv1DAUhS0EomVgzQ5ZYtPNtNd2EscskEYj-pCqViqwYGV5nJvGoyQOtjOl_x6XPlS6ur7y56NzfAj5yOBQCAVHboth6phikjEoxCuyz6oKlkUF7PWz8x55F-MWQNRFpd6SPVGBrGVZ75N0gXPwDe6w99OAY6KXc7J-QOpGuu5c3wQc6Y1LHT3GZHp6EvxNXq4wpuBscn6kJtHv7g_9hSZE6lu6usYvdJWRFHycMEM7pGvf-ZDBNDe378mb1vQRPzzMBfl5_O3H-nR5fnlytl6dL23BWVqqUhRQslLWoASWyhbAipZvasktlxUANyAbqaCpOELVWmVaVXOBot2AlRuxIF_vdad5M2Bjc7xgej0FN5hwq71x-v-b0XX62u-0KlldlioLHDwIBP97zpH14KLFvjcj-jlqLhmvs8N_6OcX6NbPYczx7ijGlRS5oAU5uqds_poYsH0yw0DfNapfNJpffHqe4Yl_rFD8BdepndY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2711297304</pqid></control><display><type>article</type><title>Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study</title><source>Publicly Available Content (ProQuest)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Benítez Marín, María José ; Blanco Elena, Juan Antonio ; Marín Clavijo, Jesús ; Jiménez López, Jesús ; Lubián López, Daniel María ; González Mesa, Ernesto</creator><creatorcontrib>Benítez Marín, María José ; Blanco Elena, Juan Antonio ; Marín Clavijo, Jesús ; Jiménez López, Jesús ; Lubián López, Daniel María ; González Mesa, Ernesto</creatorcontrib><description>This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support. It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied. The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient. We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph191711043</identifier><identifier>PMID: 36078758</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Animal cognition ; Behavior ; Birth Weight ; Child ; Child, Preschool ; Children ; Cognition ; Cognitive development ; Cohort analysis ; Communication skills ; Delay ; Female ; Fetal Growth Retardation - epidemiology ; Fetuses ; Gestational Age ; Hemodynamics ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Mean ; Motor skill ; Neonates ; Neurodevelopment ; Preeclampsia ; Pregnancy ; Premature babies ; Quotients ; Retrospective Studies ; Sociodemographics ; Socioeconomics ; Ultrasonography, Prenatal ; Umbilical Arteries - diagnostic imaging</subject><ispartof>International journal of environmental research and public health, 2022-09, Vol.19 (17), p.11043</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-9534051578093e59c4014f2b872c276002a07d790d62e06fc9af9823e3fb0c7b3</citedby><cites>FETCH-LOGICAL-c421t-9534051578093e59c4014f2b872c276002a07d790d62e06fc9af9823e3fb0c7b3</cites><orcidid>0000-0002-7286-8656 ; 0000-0002-7106-092X ; 0000-0002-2603-5477 ; 0000-0001-8861-1751</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2711297304/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2711297304?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36078758$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benítez Marín, María José</creatorcontrib><creatorcontrib>Blanco Elena, Juan Antonio</creatorcontrib><creatorcontrib>Marín Clavijo, Jesús</creatorcontrib><creatorcontrib>Jiménez López, Jesús</creatorcontrib><creatorcontrib>Lubián López, Daniel María</creatorcontrib><creatorcontrib>González Mesa, Ernesto</creatorcontrib><title>Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study</title><title>International journal of environmental research and public health</title><addtitle>Int J Environ Res Public Health</addtitle><description>This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support. It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied. The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient. We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.</description><subject>Animal cognition</subject><subject>Behavior</subject><subject>Birth Weight</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cognition</subject><subject>Cognitive development</subject><subject>Cohort analysis</subject><subject>Communication skills</subject><subject>Delay</subject><subject>Female</subject><subject>Fetal Growth Retardation - epidemiology</subject><subject>Fetuses</subject><subject>Gestational Age</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Small for Gestational Age</subject><subject>Mean</subject><subject>Motor skill</subject><subject>Neonates</subject><subject>Neurodevelopment</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Premature babies</subject><subject>Quotients</subject><subject>Retrospective Studies</subject><subject>Sociodemographics</subject><subject>Socioeconomics</subject><subject>Ultrasonography, Prenatal</subject><subject>Umbilical Arteries - diagnostic imaging</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkUtv1DAUhS0EomVgzQ5ZYtPNtNd2EscskEYj-pCqViqwYGV5nJvGoyQOtjOl_x6XPlS6ur7y56NzfAj5yOBQCAVHboth6phikjEoxCuyz6oKlkUF7PWz8x55F-MWQNRFpd6SPVGBrGVZ75N0gXPwDe6w99OAY6KXc7J-QOpGuu5c3wQc6Y1LHT3GZHp6EvxNXq4wpuBscn6kJtHv7g_9hSZE6lu6usYvdJWRFHycMEM7pGvf-ZDBNDe378mb1vQRPzzMBfl5_O3H-nR5fnlytl6dL23BWVqqUhRQslLWoASWyhbAipZvasktlxUANyAbqaCpOELVWmVaVXOBot2AlRuxIF_vdad5M2Bjc7xgej0FN5hwq71x-v-b0XX62u-0KlldlioLHDwIBP97zpH14KLFvjcj-jlqLhmvs8N_6OcX6NbPYczx7ijGlRS5oAU5uqds_poYsH0yw0DfNapfNJpffHqe4Yl_rFD8BdepndY</recordid><startdate>20220903</startdate><enddate>20220903</enddate><creator>Benítez Marín, María José</creator><creator>Blanco Elena, Juan Antonio</creator><creator>Marín Clavijo, Jesús</creator><creator>Jiménez López, Jesús</creator><creator>Lubián López, Daniel María</creator><creator>González Mesa, Ernesto</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7286-8656</orcidid><orcidid>https://orcid.org/0000-0002-7106-092X</orcidid><orcidid>https://orcid.org/0000-0002-2603-5477</orcidid><orcidid>https://orcid.org/0000-0001-8861-1751</orcidid></search><sort><creationdate>20220903</creationdate><title>Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study</title><author>Benítez Marín, María José ; Blanco Elena, Juan Antonio ; Marín Clavijo, Jesús ; Jiménez López, Jesús ; Lubián López, Daniel María ; González Mesa, Ernesto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-9534051578093e59c4014f2b872c276002a07d790d62e06fc9af9823e3fb0c7b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Animal cognition</topic><topic>Behavior</topic><topic>Birth Weight</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Cognition</topic><topic>Cognitive development</topic><topic>Cohort analysis</topic><topic>Communication skills</topic><topic>Delay</topic><topic>Female</topic><topic>Fetal Growth Retardation - epidemiology</topic><topic>Fetuses</topic><topic>Gestational Age</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Small for Gestational Age</topic><topic>Mean</topic><topic>Motor skill</topic><topic>Neonates</topic><topic>Neurodevelopment</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Premature babies</topic><topic>Quotients</topic><topic>Retrospective Studies</topic><topic>Sociodemographics</topic><topic>Socioeconomics</topic><topic>Ultrasonography, Prenatal</topic><topic>Umbilical Arteries - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benítez Marín, María José</creatorcontrib><creatorcontrib>Blanco Elena, Juan Antonio</creatorcontrib><creatorcontrib>Marín Clavijo, Jesús</creatorcontrib><creatorcontrib>Jiménez López, Jesús</creatorcontrib><creatorcontrib>Lubián López, Daniel María</creatorcontrib><creatorcontrib>González Mesa, Ernesto</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of environmental research and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benítez Marín, María José</au><au>Blanco Elena, Juan Antonio</au><au>Marín Clavijo, Jesús</au><au>Jiménez López, Jesús</au><au>Lubián López, Daniel María</au><au>González Mesa, Ernesto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study</atitle><jtitle>International journal of environmental research and public health</jtitle><addtitle>Int J Environ Res Public Health</addtitle><date>2022-09-03</date><risdate>2022</risdate><volume>19</volume><issue>17</issue><spage>11043</spage><pages>11043-</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><abstract>This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support. It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied. The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient. We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36078758</pmid><doi>10.3390/ijerph191711043</doi><orcidid>https://orcid.org/0000-0002-7286-8656</orcidid><orcidid>https://orcid.org/0000-0002-7106-092X</orcidid><orcidid>https://orcid.org/0000-0002-2603-5477</orcidid><orcidid>https://orcid.org/0000-0001-8861-1751</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1660-4601
ispartof International journal of environmental research and public health, 2022-09, Vol.19 (17), p.11043
issn 1660-4601
1661-7827
1660-4601
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9518559
source Publicly Available Content (ProQuest); PubMed Central; Free Full-Text Journals in Chemistry
subjects Animal cognition
Behavior
Birth Weight
Child
Child, Preschool
Children
Cognition
Cognitive development
Cohort analysis
Communication skills
Delay
Female
Fetal Growth Retardation - epidemiology
Fetuses
Gestational Age
Hemodynamics
Humans
Infant, Newborn
Infant, Small for Gestational Age
Mean
Motor skill
Neonates
Neurodevelopment
Preeclampsia
Pregnancy
Premature babies
Quotients
Retrospective Studies
Sociodemographics
Socioeconomics
Ultrasonography, Prenatal
Umbilical Arteries - diagnostic imaging
title Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T16%3A57%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Neurodevelopment%20Outcome%20in%20Children%20with%20Fetal%20Growth%20Restriction%20at%20Six%20Years%20of%20Age:%20A%20Retrospective%20Cohort%20Study&rft.jtitle=International%20journal%20of%20environmental%20research%20and%20public%20health&rft.au=Ben%C3%ADtez%20Mar%C3%ADn,%20Mar%C3%ADa%20Jos%C3%A9&rft.date=2022-09-03&rft.volume=19&rft.issue=17&rft.spage=11043&rft.pages=11043-&rft.issn=1660-4601&rft.eissn=1660-4601&rft_id=info:doi/10.3390/ijerph191711043&rft_dat=%3Cproquest_pubme%3E2712851559%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c421t-9534051578093e59c4014f2b872c276002a07d790d62e06fc9af9823e3fb0c7b3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2711297304&rft_id=info:pmid/36078758&rfr_iscdi=true